PD07-04 ROLE OF UNILATERAL ADRENALECTOMY IN BILATERAL PRIMARY ALDOSTERONISM

Abstract

You have accessJournal of UrologyAdrenal (PD07)1 Sep 2021PD07-04 ROLE OF UNILATERAL ADRENALECTOMY IN BILATERAL PRIMARY ALDOSTERONISM Yu-Cheng Lu, Kuo-How Huang, Vin-Cent Wu, Kwan-Dun Wu, and Fang-Yu Cha Yu-Cheng LuYu-Cheng Lu More articles by this author , Kuo-How HuangKuo-How Huang More articles by this author , Vin-Cent WuVin-Cent Wu More articles by this author , Kwan-Dun WuKwan-Dun Wu More articles by this author , and Fang-Yu ChaFang-Yu Cha More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001975.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Mineralcorticoid receptor antagonist was the first-line treatment in bilateral adrenal hyperplasia (BAH) with primary aldosteronism (PA). Some patients were refractory to medical treatment and required second line therapy, such as unilateral adrenalectomy (UA). In this study, we investigated blood pressure and biochemical responses and identified predictive factors in patients with PA after UA. METHODS: From January, 2010 to November, 2018, 102 patients with complete adrenal vein sampling (AVS) as well NP-59 test and confirmatory diagnoses of PA were enrolled. All these patients received UA and followed up for 12 months subsequently. We collected and analyzed all possible correlated parameters that might interfere the clinical and biochemical outcomes. RESULTS: A total of 102 patients were stratified into two groups by AVS and NP-59 results: 20 (19.6%) patients had BAH in Group A and 82 (80.4%) patients had unilateral lesion in Group B. Patients in Group B had better blood pressure control after UA (p<0.001). Both groups had significant improvement in serum aldosterone-renin ratio (ARR), potassium level and reduction of anti-hypertensive drugs. (Group A: p=0.013, p=0.003 and p=0.020 respectively; Group B: p<0.001, p<0.001 and p<0.001 respectively). Patients in Group A had worse clinical outcome with 40% failure rate (p=0.020) but there was no difference in biochemical outcome (p=0.065). Multivariate logistic regression analysis indicated that preoperative ARR (OR: 0.999, p=0.031) could predict biochemical success at 12-month after UA but there were no predictors found for clinical success. CONCLUSIONS: Patients with bilateral PA generally had worse clinical outcome after UA. However, significantly reduced ARR, serum potassium and usage of anti-hypertensive drugs were noted after UA. This study indicated that UA could be beneficial in some patients with bilateral PA and should not be excluded as a treatment option. Source of Funding: No © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e106-e106 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yu-Cheng Lu More articles by this author Kuo-How Huang More articles by this author Vin-Cent Wu More articles by this author Kwan-Dun Wu More articles by this author Fang-Yu Cha More articles by this author Expand All Advertisement Loading ...